ESSLei - Mestrado em Fisioterapia - Área de Especialização em Fisioterapia Pediátrica
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- PARENTS´ PERCEPTIONS ON THE EFFECTIVENESS OF PEDIATRIC CHEST PHYSIOTHERAPY FOR BRONCHIOLITIS: A NATIONAL SURVEYPublication . Braz, Alexandra Isabel Simões Saúde; Cruz, Joana Patrícia dos Santos; Faustino, Raquel Maria de Carvalho; Silva, Cândida Susana Gonçalves daAcute bronchiolitis is the most common cause of hospitalization for lower respiratory tract infections caused by respiratory syncytial virus in children under the age of two. It is known that most parents do not seek chest physiotherapy promptly, which can lead to a worsening of the condition. This knowledge is essential to increase adherence to treatment, educate parents and encourage their active participation through knowledge of the benefits and adverse events in patients undergoing chest physiotherapy. Aims: The primary objective of this study was to explore parents' knowledge and perception of chest physiotherapy in children diagnosed with bronchiolitis. Specifically, in the group that received chest physiotherapy sessions, we sought to determine parents' knowledge and perceived benefits. As a secondary objective, we sought to understand the potential adverse events of chest physiotherapy and relate the severity of bronchiolitis to variables related to physiotherapy. In the group that did not undergo chest physiotherapy sessions, we explored the reasons why parents did not seek chest physiotherapy sessions for their children. Methods: An online, survey-based cross-sectional study was carried out in Portugal, involving parents of children diagnosed with bronchiolitis, divided into 2 groups: Group 1 – those who had never undergone chest physiotherapy, and Group 2 – those whose children had undergone chest physiotherapy at least once. Parents were recruited via social media and from the researchers' network of contacts. Data collection was conducted between March and May 2025 and included demographic and clinical characteristics. Descriptive statistics were performed to characterize the sample and describe the results, and potential- group differences between the stages of bronchiolitis as well as potential differences between groups in relation to the stages of bronchiolitis and in relation to parents' knowledge/perceptions and the chest physiotherapy techniques used in the intervention, using chi-square and Fisher's exact tests. Results: A total of 100 participants were included: Group 1- 44% whose children did not receive chest physiotherapy (n=44) and Group 2- 56% of respondents whose children received chest physiotherapy (n=56). The majority of respondents (n=70, 70%) resided in Lisbon, were between 30 and 39 years old, and 90% were the children’s mothers (n=90). The children diagnosed with bronchiolitis were between 7 and 9 months old (n=24, 24%), and 20% were diagnosed with mild bronchiolitis (n=20), 34% with moderate bronchiolitis (n=34), and 2% with severe bronchiolitis (n=2). Regarding Group 1, respondents reported not having chest physiotherapy due to the lack of medical recommendation (n=25, 56.8%) and lack of information about the benefits of chest physiotherapy (n=12, 25%). In Group 2, most had 1 to 2 chest physiotherapy sessions (n=33, 58.9%), reported that the sessions were held in outpatient clinics (n=31, 55.4%), and identified as benefits the reduction of pulmonary secretions (n=47, 83.9%), decreased nasal obstruction (n=39, 69.6%), and reduced coughing frequency (n=29, 51.8%). Physiotherapists advised respondents (n=36, 64.3%) to apply certain techniques at home, with nasal irrigation being the most recommended (n=32, 57.1%). Approximately 19.6% of respondents (n=11) reported adverse events, such as extreme tiredness, vomiting, petechiae, and changes in heart rate, which occurred once in most cases (n=9, 16.1%) and 2–3 times in a few cases (n=2, 3.6%). Reported barriers included the cost of treatment (n=36, 64.3%), followed by lack of knowledge about chest physiotherapy and the absence of referral by a doctor or other healthcare professional (n=21, 37.5%). Statistically significant associations were observed between the severity of bronchiolitis and improvements in feeding, reduced hospitalization time, and parents' perception of the most relevant aspects of the session about session frequency and bronchiolitis severity (p<0.05). Conclusion: This study showed that a significant number of parents do not pursue chest physiotherapy for their children, indicating gaps in awareness and access. The findings emphasize the necessity of enhancing communication between healthcare professionals and parents to ensure the delivery of clear, evidence-based information regarding the benefits and indications of chest physiotherapy.